The Ultrasound

I went in on Friday for my pelvic ultrasound and was excited and curious to see what had been happening inside my body since the last one back in 2007. The technician was very professional and very kind. She instructed me on how to prepare for the exam, then told me that she would let me know what she was seeing as she saw it, but that of course the final diagnosis would be up to my doctor. I was pretty excited to be able to get some information right away instead of having to wait several days for the official report. The last time I had an ultrasound, the technician was wary of revealing any information. While I understand not wanting to either give someone false hope or upset them for no good reason, I felt like I was prepared enough to handle whatever she told me.

I lay on my back and kept my eyes glued to the monitor that showed pictures of my uterus, ovaries and fallopian tubes. In truth it all just looked like black and white smudges that changed shape as the technician moved the probe, but when she pointed out my cervix and then my uterus I felt such a sense of wonder at the miracles of both modern technology and the human body. To think that I was at that moment seeing a picture of the space where one day my baby might grow. Amazing.

The technician busied herself with measuring and snapping pictures of different images but talked to me as she did so. "We'll start with your uterus and go from there. Oh that looks good. You have a nice thickness to your endometrium (lining of the uterus) that corresponds to where you are in your cycle. That black part there is just some free-floating fluid in your abdomen, and this here looks to me like a simple cyst. But this--this looks very much like an endometrioma on your left ovary and another one here."

She moved the probe around some more and took more measurements and more pictures. I watched what looked like a dotted line move across a big portion of the screen as she locked the measurements into place. Just how big were these endometriomas anyway? "Now let's look at your right ovary." She tilted the probe and began measuring again. "It looks like there's another endometrioma hanging off the side of the ovary here. I can't quite tell what this part here is--could be incorporating part of the fallopian tube too." My heart dropped when she said those words because in the last test, it had only been my left ovary that showed signs of an endometrioma; my right ovary had been unaffected as had both of my fallopian tubes.

She finished up the test by telling me that my uterus looked fine (yay!) but that I seemed to have several endometrioma-like growths affecting both my ovaries. She left the room and while I dressed, I looked at the string of photos coming out of the machine. They were the same type of photos expectant parents get after they have an ultrasound of their developing baby. Instead of showing a tiny profile or hands and feet, these photos showed tissue that should be growing inside the uterus--not outside it on my other reproductive organs. I gathered my things and met the technician in the hallway. "I'll put these photos on the doctor's desk right away and she'll contact you." I thanked her and left, going over her words in my mind. Did she see something that looked more worrisome than endometriosis? Was that concern in her face or pity? Or was I imagining there was anything there other than professional courtesy?

I should hear from the doctor sometime this week.

Part 2, Step 1

Most everything I have done in the past to help me get pregnant has been following some type of natural medicine protocol, ie. a specialized diet, nutritional supplements, abdominal massage, etc. It has been many months since I have followed any type of plan to help me conceive and it's partly from lack of health insurance over the past 2 years (and jobs for the greater part of last year) and partly from a sense of deep discouragement and wallowing in the deepest pit of self-pity.

I have been fighting a sense of rising panic over the fact that my 36th birthday is just around the bend while at the same time telling myself that the baby(s) will come when the time is right and I cannot make anything happen. What will be will happen in its own time. Still. I feel that it's pretty obvious I need to do my part in creating the best possible environment for a baby and my own best state of fertility in order for said baby to make his/her appearance. With that has come a renewed sense of "let's get to it!" in my mind and heart these past few weeks.

I knew that the very first step (and that is what I have to focus on is just one step at a time, or I will become completely overwhelmed) would be to go in for my annual exam to make sure that my body is healthy. I hadn't had one in two years due to the aforementioned lack of health insurance.

I found a doctor and steeled myself for the visit; it's always tough for me to go to a woman's health clinic where I am sure to see at least one pregnant woman. I was pleased (and a little bit concerned) that the waiting room was absolutely empty when I got there. What kind of place was this that had no patients? My mom pointed out later that my appointment was probably the first after the office lunch hour ended and I felt reassured. While I wasn't eager to see a pregnant belly, I did want to know that I was in good hands!

The doctor was pleasant if a bit on the extreme end of the peppiness and chattiness spectrum. I was once again struck by the difference between a visit to a Western medicine practitioner and an Eastern medicine practitioner. She had a smile on her face the whole time we talked, yet I didn't feel like she really saw me or was open to hearing about all aspects of my health. Her focus was my physical body--not my mental, emotional or spiritual health. You might wonder why I didn't just go to a naturopathic doctor for my annual exam since I am so much more at ease in that type of environment. The truth is, sadly, that my insurance will not pay for it--for the exact same test but performed by a doctor schooled in a tradition other than Western medicine. Incredible, isn't it?

Anyway, the doctor asked me the usual questions about how long we'd been trying and what kind of diagnostic testing we'd had. I had indicated on my health history form that I'd like to be referred for a pelvic ultrasound since I'd had one a couple years earlier and I'd had what looked like an endometrioma (fluid-filled cyst caused by endometriosis) encompassing the greater part of my left ovary. I was curious as to whether it had resolved itself, gotten bigger or stayed the same since I wasn't having the sharp pain in my side that had been the reason for the previous test.

The doctor asked if I'd had an HSG (hysterosalpingogram) which costs around $600 and is usually not covered by health insurance since it's used as a diagnostic tool for fertility. Dye is injected into the uterus and flows out the fallopian tubes, if they are not blocked by scarring and adhesions. If the test shows the tubes are blocked, it's an indicator (in Western medicine) that the next step in achieving pregnancy had better be an IVF (invitrofertilization) procedure which bypasses them altogether.

I told her I was interested in having an IVF consult and she gave me a brochure on the doctors at Oregon Reproductive Medicine. She giggled, lowered her voice and glanced toward the exam room door like she thought someone in the hallway might be eavesdropping and confided that it was where she had gone to become pregnant with her two children. At this point I felt like she was just way too cheery and high-energy for me, but I smiled, nodded and said, "Oh, that's good."

Next came the exam, in which she said she couldn't really feel anything that might be an endometrioma on my ovaries, but that my uterus was moving well--a good sign, since if it wasn't movable, it could be an indicator of adhesions gluing it in place or to other organs.

I met her in the hallway after the exam and she loaded me up with paperwork: orders for a blood test for me, a sperm analysis for Michael, an HSG for me (should I choose to fork over the money for it) and a booklet entitled "Infertility Problems; A Guide to Understanding Your Options" that detailed the organs of the male and female anatomy and explained all of the things that must happen at just the right time and in just the right amount in order for a fertilized embryo to implant in the uterus. It blows me away every time I read about it--this miraculously choreographed and performed ballet, this journey of sperm and egg.

I scheduled a pelvic ultrasound for the following Friday and left the doctor's office clutching my sheaf of paperwork and feeling fairly optimistic. I had a sense of leaving my struggles of the past few years behind me and starting with a clean slate. What remained was to sift through the possibilities and determine what further steps felt right for me, as an individual and not as a statistic or a health condition. Whatever happened next, I knew I would do my best to conceive and carry my own child but that somehow, someway, I would become a mother.

Why A Blog?

It's no secret to most of you reading this that Michael and I have been trying to become parents for a very long time--well, I suppose 5 years isn't so long in the grand scheme of things, but for me it has seemed an eternity. I have been up and down and all over the map in terms of how I feel about this journey we are on. I've gone from hopeful to desperate to inspired to devastated hundreds of times--sometimes just during the course of one day. I know that I have probably made much more progress than it feels like I have made, but I hope this journal will help me keep better track and prove to myself that I am doing something to help my dreams become reality.

I invite you, dear friend, along for the ride.